The Columbia River Oncology Program (CROP), a Community Clinical Oncology Program (CCOP) currently in its 22nd year, is a consortium of four health care systems in the metropolitan Portland, Oregon/Vancouver, Washington area. These health care systems encompass: Adventist Medical Center, Legacy Health System, Providence Health System, and Southwest Washington Medical Center. CROP'S specific aims are: 1) Enhance the health of our community by providing and promoting cancer treatment, cancer prevention and cancer control research studies, 2) Seek opportunities to mirror the diversity of our community by providing complementary and holistic clinical research studies, 3) Advocate for and participate in clinical trials providing symptom management, improved quality of life, and palliative care for our cancer patient population, 4) Increase our physician alliances and commitments to clinical trials and increase accrual goals, and 5) Expand participation of minorities and the underserved population to participate in cancer prevention, cancer control and treatment studies. CROP currently affiliates with seven research bases: COG, MDACC, NCCTG, NSABP, RTOG, SWOG, and URCC. All are multi-specialty cooperative groups that supply CROP with NCI approved cancer prevention, cancer control and cancer treatment protocols. The established functioning operational status of CROP includes an Executive Board with representative committee structure, a central office, and actively participating hospital systems. The central office staff coordinates the administrative aspects of CROP, the large cancer prevention studies and quality improvement activities. The Clinical Trial Nurses and Clinical Research Associates employed by the consortium hospitals recruit patients to cancer control and treatment protocols collect and submit data to the research bases, participate in the quality improvement process, and actively participate in the research base meetings. Each organization employs a pharmacist to manage the investigational agents for CROP.